No app or algorithm can ever replace a GP, says RCGP

By Professor Martin Marshall on the
27 June 2018

Health technology company Babylon has said that its AI system can outperform the average doctor in diagnostic elements of the MRCGP exams. The college's vice chair Professor Martin Marshall says those claims are dubious - read his full response below.

The potential of technology to support doctors to deliver the best possible patient care is fantastic, but at the end of the day, computers are computers, and GPs are highly-trained medical professionals: the two can’t be compared and the former may support but will never replace the latter.

No app or algorithm will be able to do what a GP does. Every day we deliver care to more than a million people across the UK, taking into account the physical, psychological and social factors that may be impacting on a patient’s health; we consider the different health conditions a patient is living with, and medications they might be taking, when formulating a treatment plan.

Much of what GPs do is based on a trusting relationship between a patient and a doctor, and research has shown GPs have a ‘gut feeling’ when they just know something is wrong with a patient.

MRCGP assessment

An app might be able to pass an automated clinical knowledge test but the answer to a clinical scenario isn’t always cut and dried, there are many factors to take into account, a great deal of risk to manage, and the emotional impact a diagnosis might have on a patient to consider.

This is why the college’s MRCGP assessment, which all GPs must now pass in order to practise independently in the UK, has three elements and is designed to test not just clinical knowledge, but also the ability to make evidence-based decisions and to deliver person-centred care through effective communication with patients and colleagues.

It is also the case that the exam-preparation materials, used by Babylon in this research, will have been compiled for revision purposes and are not necessarily representative of the full-range of questions and standard used in the actual MRCGP exam, so to say that Babylon’s algorithm has performed better than the average MRCGP candidate is dubious.

GP at Hand

Babylon’s GP at Hand service uses technology in a way that some patients like. But some don’t, and the way it is being used risks undermining and damaging traditional general practice services.

The college has publicly criticised GP at Hand for ‘cherry-picking’ patients, leaving traditional GP services to deal with the most complex patients, without sufficient resources to do so. We stand by this: we do not endorse Babylon, or its GP at Hand service, being used in the way that it is, in the NHS.

Technology has the potential to transform the NHS, but it must be implemented in an equitable way, that doesn’t benefit some patients, and not others, and is not to the detriment of the general practice service as a whole.